乳腺X线摄影及超声检查对不同病理类型及分子分型青年乳腺癌的诊断价值  

Diagnostic value of mammography and ultrasound in different pathological types and molecular types of breast cancer in young women

作　　者：高文怡 孙悦 努尔也木·麦麦提 姚娟 GAO Wenyi;SUN Yue;NUERYEMU·Mai maiti;YAO Juan(Department of Imaging Center,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China;Department of Nuclear Medicine,Xinjiang Yili Friendship Hospital,Yili 835000,China;Imaging Center,Changji branch,the First Affiliated Hospital,Xinjiang Medical University,ChangJi 831100,China)

机构地区：[1]新疆医科大学第一附属医院影像中心,新疆乌鲁木齐830000 [2]新疆伊犁州友谊医院核医学科,新疆伊犁835000 [3]新疆医科大学第一附属医院昌吉分院影像中心,新疆昌吉831100

出　　处：《医学影像学杂志》2024年第2期42-45,共4页Journal of Medical Imaging

基　　金：国家自然科学基金资助项目(编号:81960339);新疆维吾尔自治区自然科学基金资助项目(编号:2019D01A85)。

摘　　要：目的 探讨乳腺X线摄影及超声检查对不同病理类型及分子分型青年女性乳腺癌的诊断价值。方法 选取我院经病理证实的青年女性乳腺癌患者87例,分析基本特征、病理类型、分子分型、影像学表现特点,对比乳腺X线摄影及超声检查的灵敏度及其联合灵敏度。结果 浸润性导管癌(invasive ductal carcinoma,IDC)为最常见病理类型(46.0%),最常见分子分型为Luminal B型(48.3%)。乳腺X线摄影中IDC常表现为不规则形,边缘模糊的肿块;IDC并导管原位癌(ductal carcinoma in situ,DCIS)以无定形、成簇或集群样分布的钙化为主;DICS以钙化或其他征象(结构扭曲或局灶性不对称)为主,钙化呈段样或弥漫性分布;其他类型癌主要表现为不规则或团块状,边缘清晰的肿块。Luminal B型以单纯钙化为主(35.7%);Luminal A型及三阴性型以肿块为主(分别为34.5%、42.9%);HER-2过表达型常表现为钙化(55.6%)。超声检查各病理类型及分子分型乳腺超声纵横比、病灶内部或(及)周围血流情况差异无统计学意义(P>0.05)。乳腺X线摄影的灵敏度为59.8%,超声检查的灵敏度为72.4%,二者结合的灵敏度为82.8%。结论 青年女性乳腺癌的个别影像学特征可用来预测肿瘤的某些病理类型。超声检查灵敏度高于乳腺X线摄影,超声检查联合乳腺X线摄影检查,可以提高灵敏度。Objective To analyze the diagnostic value of mammography and ultrasound in young women with different pathological types and molecular types of breast cancer.Methods Eighty-seven cases of young women with breast cancer confirmed by pathology in our hospital were retrospectively analyzed.The basic features,pathological types,molecular typing and image features were analyzed,and the sensitivity and combined diagnostic rate of X-ray and ultrasonography were compared.Results Invasive ductal carcinoma(IDC)was the most common pathological type(46.0%),and the most common molecular subtype was Luminal B(48.3%).On mammography,IDC often appeared as an irregular mass with blurred edges.IDC and ductal carcinoma in situ(DCIS)were mainly amorphous,clustered or clustered calcification.DCIS showed calcification or other signs(structural distortion or focal asymmetry),and calcification showed segmental or diffuse distribution.Other types of cancer mainly presented as irregular or massive masses with well-defined edges.Luminal B type was mainly calcified(35.7%).Luminal A type and triple negative type were mainly mass(34.5%and 42.9%,respectively).Calcification was common in HER-2 overexpression(55.6%).There was no significant difference in aspect ratio and blood flow in and around breast lesions among different pathological types and molecular subtypes(all P>0.05).The sensitivity of mammography,ultrasound,and the combination of the both was 59.8%,72.4%and 82.8%,respectively.Conclusions Individual radiographic features of breast cancer in young women can be used to predict certain pathologic types of tumor.The sensitivity of ultrasonography is higher than that of mammography.Ultrasonography combined with mammography can improve the sensitivity.

关 键 词：青年女性 乳腺癌 病理 乳腺X线摄影 超声检查 

分 类 号：R737.9[医药卫生—肿瘤] R445[医药卫生—临床医学]